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Kohake K, Henning L, Dahl S, Neuber N, Dreiskämper D. Associations between physical activity and health-related factors in childhood and adolescence during COVID-19 pandemic: A systematic review. J Sports Sci 2025:1-24. [PMID: 40402076 DOI: 10.1080/02640414.2025.2508041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2025]
Abstract
Today, there is clear evidence that the restrictions of the COVID-19 pandemic influenced not only the physical activity (PA) behaviour of children and adolescents but also different health parameters. This study aimed at analysing the relationship between PA and health in children and adolescents during the COVID-19 pandemic. A systematic review in accordance with PRISMA was conducted. In April 2022, studies were searched for in nine electronic databases. Overall, 58 papers investigating more than 80,000 children and adolescents from 26 countries met full inclusion criteria. Studies examined the associations between PA and psychological health (n = 45), physical health (n = 13), social health (n = 12), general health (n = 1), and health-related habits (i.e. sleep, nutrition, screen time; n = 17). Most studies demonstrated strong evidence for relationships between PA and psychological health. Mostly positive correlations also emerged regarding the relation of PA and physical as well as social health. PA is also associated with other health-related behaviours, with screen time having an exceptional role during the pandemic. This review indicates that PA and health are associated largely even during the changed conditions of the COVID-19 pandemic. Future studies are needed that focus on the causality of these relationship between PA and health by including studies with longitudinal designs.
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Affiliation(s)
- K Kohake
- Department of Physical Education and Teaching Research, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - L Henning
- Department of Sport and Exercise Psychology, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - S Dahl
- Department of Physical Education and Teaching Research, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - N Neuber
- Department of Physical Education and Teaching Research, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - D Dreiskämper
- Department of Sport and Exercise Psychology, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
- Department of Sports Psychology, Institute of Sport and Exercise Sciences, TU Dortmund University, Dortmund, Germany
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Suárez-Reyes M, Fernández-Verdejo R, Quintiliano D, Pinheiro AC, Pizarro T. Effects of school closure on lifestyle behaviours and health outcomes in children during the COVID-19 pandemic in Chile: A time-matched analysis. Pediatr Obes 2024; 19:e13182. [PMID: 39379176 PMCID: PMC11560478 DOI: 10.1111/ijpo.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/13/2024] [Accepted: 09/20/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND The COVID-19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self-esteem, self-concept) in children. METHODS We measured 247 children before school closure (October-November 2019) and after school reopening (October-November 2021) (COVID-19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age-matched children with cross-sectional measurements in October-November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two-way ANOVA was used to test age-by-group interactions, indicating an effect of school closure. RESULTS In 7-to-9-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger-than-expected increases in fat percentage (by 6.1 percent point). In 8-to-10-year-old children, the COVID-19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger-than-expected increases in fat percentage (by 8.3 percent points), z-score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9-to-11-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.3 points) and increases in self-concept (by 0.2 points). The response in dietary habits, fitness, or self-esteem was not different between groups. CONCLUSION Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children.
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Affiliation(s)
- Mónica Suárez-Reyes
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile
| | - Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Daiana Quintiliano
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Anna Cristina Pinheiro
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Tito Pizarro
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile
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Zarate-Osuna F, Quesada-González C, Zapico AG, González-Gross M. Overweight Prevalence Changes Before and After COVID-19 in Spain: The PESCA Program Longitudinal Outcomes 2018-2021. Nutrients 2024; 16:3993. [PMID: 39683387 DOI: 10.3390/nu16233993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 11/12/2024] [Accepted: 11/18/2024] [Indexed: 12/18/2024] Open
Abstract
Background: Overweight prevalence in Spain reached critical levels before the COVID-19 pandemic, which likely exacerbated this issue. The PESCA (Programa Escolar de Salud Cardio-vascular) program is a multicomponent school-based intervention, launched in 2018 with the aim of tackling this health problem and reducing overweight rates in youth. Objectives: (1) To analyze the efficacy of the PESCA program intervention on body composition, overweight prevalence, physical activity (PA)/sport practice, resting time, and screentime before COVID-19 and (2) to evaluate the impact of COVID-19 and the associated lockdown measures on these parameters in the studied sample. Methods: This longitudinal study included 207 children and adolescents from schools in Madrid (aged 2.82 to 15.84 years; 44.4% girls), with measurements taken at three time points: two before COVID-19 and one after its onset. Overweight prevalence, body fat percentage diagnosis, physical activity, resting time, and screentime were assessed. Cochran's Q test and repeated-measures ANOVA were used to compare outcomes across the three assessment time points. Results: Overweight prevalence remained stable among children in the PESCA program before COVID-19 (17.87% to 19.81%). However, a significant increase was observed from point 2 to point 3, post-COVID-19 onset (19.81% to 26.57%). Similarly, healthy body composition significantly deteriorated from 63.16% at point 2 to 52.48% at point 3. PA/sport practice prevalence significantly increased until COVID-19 onset (80.19% to 91.22%) but declined thereafter (91.22% to 79.10% from point 2 to point 3). Although the differences were small, resting time significantly decreased post-COVID-19 onset (from 10.18 h at point 2 to 9.96 h at point 3), with no changes in the first period. Non-academic screentime showed a similar pattern: stable before COVID-19 and significantly increased after its onset (1.61 h at point 1; 1.70 h at point 2; 2.29 h at point 3). Conclusions: The PESCA program positively impacted PA/sport practice prevalence and may have provided some protection against overweight and related variables during the pre-COVID period. However, health authorities' restrictions and lockdown policies during COVID-19 negatively affected the health and lifestyle variables studied, offsetting previous improvements.
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Affiliation(s)
- F Zarate-Osuna
- ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Pediatric Department, Quirónsalud Sur Hospital, 28922 Alcorcón, Spain
- Pediatric Department, Quirónsalud Toledo Hospital, 45001 Toledo, Spain
| | - C Quesada-González
- ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Department of Applied Mathematics to Information and Communication Technologies, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - A G Zapico
- ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - M González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
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Borger O, Segev-Becker A, Perl L, Ben Simon A, Yackobovitch-Gavan M, Sheppes T, Brener A, Oren A, Lebenthal Y. Body composition, metabolic syndrome, and lifestyle in treatment-naïve gender-diverse youth in Israel. Pediatr Obes 2024; 19:e13159. [PMID: 39155469 DOI: 10.1111/ijpo.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 07/11/2024] [Accepted: 07/14/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND There is a scarcity of published studies evaluating transgender/gender-diverse youth before initiating gender-affirming hormones. AIM To study the body composition, metabolic syndrome (MetS) components and lifestyle habits in treatment-naïve transgender youth. METHODS Cross-sectional study evaluating 153 transgender youth [median age 15.7 years, 94 transgender males] who attended The Israeli Children and Adolescents Gender Clinic between 6/2021-12/2022. Clinical, metabolic data and lifestyle habits (diet, physical activity and sleep patterns) were retrieved from the medical files. Body composition was determined by bioelectrical impedance analysis. Body mass index and muscle-to-fat ratio z-scores were calculated by sex designated at birth. RESULTS Weight categories differed between genders, with a greater proportion of subjects classified as underweight among transgender females, and a greater proportion affected by overweight/obese/severe obese among transgender males (p = 0.035). The odds for MetS components were increased by 2.2 for every 1 standard deviation decrease in the muscle-to-fat ratio z-score (95%CI: 1.45 to 3.26, p < 0.001). About one-third of the cohort did not meet any of the three lifestyle recommendations. Transgender males had increased odds for MetS components by 3.49 (95%CI: 1.63 to 7.44, p = 0.001). CONCLUSIONS Treatment-naïve transgender-male adolescents have an imbalance between muscle and adipose tissue, which places them at increased susceptibility for MetS components even prior to hormonal treatment.
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Affiliation(s)
- Ophir Borger
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- The Nutrition & Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anat Segev-Becker
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Perl
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Ben Simon
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Sheppes
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- The Psychological Services, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avivit Brener
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Oren
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lebenthal
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Dana-Dwek Children's Hospital, Tel Aviv, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Samigullin A, Groß G, Gählert J, Buchenberger S, Morcos M, Schwertz R, Öste R, Siegel E, Humpert P. Impact of Covid-19 lockdowns on the anthropometric development in primary school children in the Rhein-Neckar Region, Germany. BMC Nutr 2024; 10:78. [PMID: 38811974 PMCID: PMC11134761 DOI: 10.1186/s40795-024-00886-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Published data suggests that lockdowns during the COVID-19 pandemic may have negatively affected children's weight development. This study aims to assess the prevalence of overweight and obesity after the COVID-19 lockdowns as well as anthropometric development among primary school children in the Rhein-Neckar Region, Germany. METHODS In this cross-sectional study, schools were selected in cooperation with the local health authority to include different socioeconomic backgrounds. Participation was voluntary at school and individual level, requiring written informed consent from legal guardians. Study visits in schools were conducted between October 2021 and July 2022. Anthropometric data from nationally recommended medical examinations at 4 years (U8) and 5 years (U9), data on nutrition, physical activity, and socioeconomic data was collected using questionnaires. zBMI and weight category were calculated based on German reference data. RESULTS 256 children with a mean age of 8.0 years (7.1-9.3 years) were included in the study. Most participants were from households with an above average income. 5.1% of the children were overweight, 4.7% were obese, 15.6% were underweight, and 74.6% were normal weight with a mean zBMI of -0.25 (SD 1.10), which is significantly lower than the mean zBMI of the German reference population (p < 0.001). No significant changes in zBMI were observed between U8 and U9 (p = 0.16). The mean zBMI decreased by 0.17 (SD 0.72) between U9 and the study visit (p = 0.02). A zBMI decrease of 0.5 was documented for the subgroup of overweight and obese children (p = 0.028) as well as a decrease of 0.23 (SD 0.63) for the normal-weight children subgroup (p < 0.001). CONCLUSIONS Contrary to previous reports mean zBMI decreased significantly in the children studied. No significant changes in zBMI were observed between U8 and U9 examinations, which supports the hypothesis that the decrease in zBMI could be attributed to lockdown measures. The study was registered at clinicaltrials.gov on September 21st 2021 under the registration number NCT05077059.
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Affiliation(s)
- Azat Samigullin
- Starscience GmbH, Heidelberg, Germany.
- Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.
| | - Gabriel Groß
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jana Gählert
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Sandra Buchenberger
- Starscience GmbH, Heidelberg, Germany
- Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany
| | - Michael Morcos
- Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | - Erhard Siegel
- St. Josefskrankenhaus, Heidelberg, Germany
- Adipositasnetzwerk Rhein-Neckar e. V., Heidelberg, Germany
| | - Per Humpert
- Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
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Dallio M, Sangineto M, Romeo M, Cipullo M, Coppola A, Mammone S, Di Gioia G, Masarone M, Persico M, Serviddio G, Federico A. The influence of acute lifestyle changes on NAFLD evolution in a multicentre cohort: a matter of body composition. Nutr Diabetes 2024; 14:33. [PMID: 38802382 PMCID: PMC11130147 DOI: 10.1038/s41387-024-00294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Unhealthy lifestyles represent a key element fueling Non-alcoholic fatty liver disease (NAFLD) onset and worsening. We aimed to evaluate the effects of forced acute lifestyle changes on NAFLD evolution. METHODS 187 NAFLD patients were followed two years pre- and two years during the lockdown social restrictions in three Italian medical centers. For each patient, biochemical, clinical, non-invasive liver fibrosis, nutritional, and body composition data were collected. RESULTS An increase in fats and carbohydrate intake associated with impaired weekly physical activity during the lockdown was demonstrated as well as an increase in body mass index and waist-hip-ratio (p < 0.0001 for all). Total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, insulin, homeostatic model assessment for insulin resistance, and transaminases worsened during the lockdown (glucose: p = 0.0007; p < 0.0001 for the others). Moreover, NAFLD fibrosis score, liver stiffness, and controlled attenuation parameter were also impaired during the same period (p < 0.0001 for all). The bioelectrical impedance analysis (BIA) evidenced an increase of fat mass (FM), and a reduction of free fat mass (FFM) and body cell mass (BCM) (p < 0.0001 for all). The lockdown overall hepatocellular carcinoma (HCC) and Milan-out HCC occurrence revealed Hazard Ratio (HR): 2.398, 95% Confidence Interval (CI):1.16-5, p = 0.02, and HR:5.931, CI:2-17.6, p = 0.008 respectively. A liver disease stage and comorbidities independent association between both the assessed outcomes and body composition analysis in terms of mean values and variation (T1-T2 Δ) was demonstrated. CONCLUSIONS The acute lifestyle changes impacted NAFLD evolution via body composition modifications negatively influencing the HCC occurrence.
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Affiliation(s)
- Marcello Dallio
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Moris Sangineto
- University Center for Research and Treatment of Liver Diseases (C.U.R.E.), Liver Unit, University of Foggia, Foggia, Italy
| | - Mario Romeo
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Marina Cipullo
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annachiara Coppola
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simone Mammone
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Di Gioia
- University Center for Research and Treatment of Liver Diseases (C.U.R.E.), Liver Unit, University of Foggia, Foggia, Italy
| | - Mario Masarone
- Department of Medicine and Surgery, "Scuola Medica Salernitana", Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Marcello Persico
- Department of Medicine and Surgery, "Scuola Medica Salernitana", Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Gaetano Serviddio
- University Center for Research and Treatment of Liver Diseases (C.U.R.E.), Liver Unit, University of Foggia, Foggia, Italy
| | - Alessandro Federico
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Averbuch S, Yackobovitch-Gavan M, Ben Simon A, Interator H, Lopez A, Borger O, Laurian I, Dorfman A, Chorna E, Oren A, Eyal O, Brener A, Lebenthal Y. Muscle-to-fat ratio in children and adolescents with type 1 diabetes in predicting glycaemic control and partial clinical remission. Diabetes Metab Res Rev 2024; 40:e3767. [PMID: 38407547 DOI: 10.1002/dmrr.3767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/13/2023] [Accepted: 01/15/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Advances in treatment could mitigate the expected adverse changes in the body composition of children and adolescents with type 1 diabetes (T1D). OBJECTIVES To examine the evolution of weight status and body composition and their association with glycaemic control and partial clinical remission in youth with T1D. METHODS Ninety-nine participants with T1D (median age 9.5 years [interquartile range 7.3, 12.9], 59.6% boys) were longitudinally followed for 3 years since diagnosis. Data at seven pre-determined time points were extracted from medical files. Outcome measures included body mass index (BMI) z-scores, muscle-to-fat ratio (MFR) z-scores, haemoglobin A1c (HbA1c) levels, continuous glucose monitoring metrics, and insulin dose-adjusted HbA1c (IDAA1c) levels. RESULTS The BMI z-scores increased significantly (p < 0.001) for both sexes, with no significant change in MFR z-scores over time. The girls had higher BMI z-scores (p < 0.001) and lower MFR z-scores than the boys (p = 0.016). The mean HbA1c levels decreased during the first month and at 3 months since diagnosis (p < 0.001), then plateaued and achieved a median overall HbA1c of 7.1% for the entire cohort. At 12 months, 37 participants (37.6%) were in partial clinical remission, as evidenced by IDAA1c ≤ 9. The odds of partial clinical remission at 2 years increased by 2.1-fold for each standard deviation increase in the MFR z-score (p < 0.001). Higher MFR z-scores were associated with better metabolic control. CONCLUSIONS Integration of body composition assessments could mitigate adverse body changes in paediatric patients with T1D.
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Affiliation(s)
- Shay Averbuch
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Ben Simon
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagar Interator
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition & Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adar Lopez
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition & Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ophir Borger
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Nutrition & Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Irina Laurian
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Nursing Services, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anna Dorfman
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Nursing Services, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Efrat Chorna
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Social Services, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Asaf Oren
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Eyal
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avivit Brener
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lebenthal
- The Institute of Pediatric Endocrinology, Diabetes and Metabolism, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Chamay-Weber C, Gelmini A, Gal-Dudding C, Maggio ABR. Impact of COVID-19 lockdown on adolescents in treatment for obesity. Arch Pediatr 2023; 30:441-444. [PMID: 37537082 DOI: 10.1016/j.arcped.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of coronavirus disease 2019 (COVID-19) lockdown on body mass index (BMI) z-score of adolescents treated for obesity, and to assess the correlation between BMI z-score changes and lifestyle variables. METHODS This cross-sectional study recruited 66 participants aged 11-18 years with overweight or obesity who attended our obesity clinics before and after the lockdown. We assessed demographic and anthropometric characteristics as well as lifestyle variables. RESULTS The mean BMI z-score of the participants was stable during this period (p = 0.233). Balanced diet, snacking, and sweet beverage consumption improved in about half of the participants. Having at least one parent at home was associated with a significantly more balanced diet (p = 0.008) and an increase in family activities (p = 0.015). Physical activities decreased (51.5%) and screen time increased for most of the adolescents (86.4%). The BMI z-score decreased significantly when three or more lifestyle habits improved (p<0.001). CONCLUSIONS This study showed that BMI z-scores were stable for a majority of adolescents treated for obesity during the COVID19 lockdown, along with positive and negative changes on weight-related lifestyle habits. This extraordinary period may have created opportunities for lifestyle modification and has emphasized the importance of family support in the management of obesity in adolescents.
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Affiliation(s)
- Catherine Chamay-Weber
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland; Adolescent Health Unit, Division of General Pediatrics, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland.
| | - A Gelmini
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland
| | - C Gal-Dudding
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland; Adolescent Health Unit, Division of General Pediatrics, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland
| | - A B R Maggio
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Women, Child and Adolescent Medicine, University Hospitals of Geneva and University of Geneva, Switzerland
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Nimali Seneviratne S, Kumarihamy Karunathilake CN, Pallegama CM, Malintha Lahiru TG, Jayarajah U. Endocrine manifestations of COVID-19 in children: A scoping review. Best Pract Res Clin Endocrinol Metab 2023; 37:101792. [PMID: 37453832 PMCID: PMC10303324 DOI: 10.1016/j.beem.2023.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
In this review, we explore associations between SARS CoV-2 infection and the endocrine system and metabolism in children and adolescents. PubMed, Scopus and Google scholar databases were searched to identify published data on endocrine manifestations of COVID-19 in children up to 31 March 2023, including diabetes, obesity, puberty, thyroid disorders, adrenal disorders and pituitary disorders. Data on changes in disease pattern/ incidence, disease control, and other effects due to the COVID-19 pandemic, as well as effects of pre-existing endocrine conditions on severity of COVID-19 infection are presented, and practice points and research needs provided under each section.
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Affiliation(s)
| | | | | | | | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Sri Lanka; Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka.
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10
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Peng B, Reeves KKL, Lee SWY, Chung THY, Hui HWL, Leung AHL, Pang JCY. Physical, psychological, and behavioral problems among children and adolescents in countries with different economic statuses during the COVID-19 pandemic: a systematic review and meta-analysis. Front Pediatr 2023; 11:1181186. [PMID: 37342536 PMCID: PMC10277820 DOI: 10.3389/fped.2023.1181186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction The COVID-19 pandemic has impacted children and adolescents' physical activity (PA), sleeping patterns, and psychological and behavioral health. Yet, little is known about the differences between those in countries with various economic statuses. Methods Articles published from database inception through 16 March 2022 were retrieved using CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO. High-quality studies that reported the number of participants with parameters associated with PA, sleeping patterns, and psychological and behavioral problems in young people aged under 18 years during the pandemic were included. We referenced the Canadian 24-Hour Movement Guidelines for PA and sleep duration to provide the event rate for young people who were not compliant with the guidelines. The event rate of young people who had decreased sleep quality and experienced psychological and behavioral problems were also investigated. A subgroup analysis was conducted to identify the differences in those in countries with diverse economic statuses. Funnel plot analysis and Egger's test were also conducted to identify any risk of publication bias. Result A total of 66 studies with 1,371,168 participants aged between 0 and 18 years, involving 27 countries, were included. During the pandemic, we identified that 41% (95% CI: 39%, 43%; I2 = 96.62) and 43% (95% CI: 34%, 52%; I2 = 99.42) of young people did not meet the PA and sleep duration recommendation guidelines. In addition, 31% (95% CI: 28%, 35%; I2 = 99.66) of young people had decreased their sleep quality. Yet, no significant difference was found across countries with different economic statuses. However, the event rates of participants with psychological and behavioral problems were 32% (95% CI: 28%, 36%; I2 = 99.85) and 19% (95% CI: 14%, 25%; I2 = 99.72), respectively. In addition, the rate of psychological problems was more severe in those who live in lower middle-income countries (p < 0.001), while the rate of behavioral problems was more severe in those who live in high-income countries (p = 0.001). Discussion During the pandemic, the discouragement of PA, poor sleep quality, and high risk of psychological and behavioral problems are concerning. A large number of young people did not comply with the recommendation guidelines. Timely implementation of recovery plans is critical to address the adverse effects on young people. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309209, identifier CRD42022309209.
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Affiliation(s)
- Bo Peng
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Kara K. L. Reeves
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
- Research Rehab Centre Limited, Hong Kong SAR, China
| | - Shara W. Y. Lee
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Tina H. Y. Chung
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Heidi W. L. Hui
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Alfred H. L. Leung
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Johnson C. Y. Pang
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
- Research Rehab Centre Limited, Hong Kong SAR, China
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11
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Ekström S, Andersson N, Kull I, Georgelis A, Ljungman PLS, Melén E, Bergström A. Changes in lifestyle, adiposity, and cardiometabolic markers among young adults in Sweden during the COVID-19 pandemic. BMC Public Health 2023; 23:1026. [PMID: 37259040 DOI: 10.1186/s12889-023-15998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted on public health in several ways. The aim of the study was to investigate changes in lifestyle, adiposity, and cardiometabolic markers among young adults in Sweden during the COVID-19 pandemic and their determinants. METHODS The study included 1 004 participants from the population-based birth cohort BAMSE. Anthropometrics, body composition (bioelectric impedance analyses), pulse, and blood pressure were measured before (December 2016-May 2019; mean age 22.6 years) and during (October 2020-June 2021; mean age 25.7 years) the COVID-19 pandemic. Lifestyle changes during the pandemic were assessed through a questionnaire. RESULTS All measures of adiposity (weight, BMI, body fat percentage, trunk fat percentage) and cardiometabolic markers (blood pressure, pulse) increased during the study period (e.g., body fat percentage by a median of + 0.8% in females, p < 0.001, and + 1.5% in males, p < 0.001). Male sex, non-Scandinavian ethnicity, BMI status (underweight and obesity), and changes in lifestyle factors, e.g., decreased physical activity during the pandemic, were associated with higher increase in BMI and/or adiposity. CONCLUSION Lifestyle factors, adiposity and cardiometabolic markers may have been adversely affected among young adults in Sweden during the COVID-19 pandemic compared with the preceding years. Targeted public health measures to reduce obesity and improve healthy lifestyle are important to prevent future non-communicable diseases.
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Affiliation(s)
- Sandra Ekström
- Center for Occupational and Environmental Medicine, Torsplan,Solnavägen 4, 113 65, Stockholm, Sweden.
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden.
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, 118 61, Stockholm, Sweden
| | - Antonios Georgelis
- Center for Occupational and Environmental Medicine, Torsplan,Solnavägen 4, 113 65, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, 182 57, Danderyd, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, 118 61, Stockholm, Sweden
| | - Anna Bergström
- Center for Occupational and Environmental Medicine, Torsplan,Solnavägen 4, 113 65, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
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12
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Natale RA, Cardenas EPV, Varanloo P, Ma R, Agosto Y, Palenzuela J, Hernandez J, Schladant M, Bloyer M, Messiah SE. Social Challenges as a Consequence of the COVID-19 Pandemic among South Florida Preschool Children with Disability and Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:619. [PMID: 37189868 PMCID: PMC10137173 DOI: 10.3390/children10040619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03-6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05-6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07-0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13-0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19-8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.
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Affiliation(s)
- Ruby A. Natale
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Erika Paola Viana Cardenas
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Parisa Varanloo
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Ruixuan Ma
- Division of Biostatistics, Department of Public Health Science, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Yaray Agosto
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Joanne Palenzuela
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Julieta Hernandez
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Michelle Schladant
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Martha Bloyer
- Department of Physical Therapy, University of Miami, Coral Gables, FL 33146, USA
| | - Sarah E. Messiah
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX 75390, USA
- Center for Pediatric Population Health, Children’s Health System of Texas and UT Health School of Public Health, Dallas, TX 75390, USA
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13
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Anderson LN, Yoshida-Montezuma Y, Dewart N, Jalil E, Khattar J, De Rubeis V, Carsley S, Griffith LE, Mbuagbaw L. Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis. Obes Rev 2023; 24:e13550. [PMID: 36721999 DOI: 10.1111/obr.13550] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/01/2022] [Accepted: 12/16/2022] [Indexed: 02/02/2023]
Abstract
Many obesity risk factors have increased during the COVID-19 pandemic, including physical inactivity, poor diet, stress, and poverty. The aim of this systematic review was to evaluate the impact of the COVID-19 pandemic, as well as associated lockdowns or restrictions, on weight change in children and adults. We searched five databases from January 2020 to November 2021. We included only longitudinal studies with measures from before and during the pandemic that evaluated the change in weight, body mass index (BMI) (or BMI z-scores for children), waist circumference, or the prevalence of obesity. Random effects meta-analyses were conducted to obtain pooled estimates of the mean difference in outcomes. Subgroups were evaluated for age groups and diabetes or obesity at baseline. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 74 studies were included (3,213,776 total participants): 31 studies of children, 41 studies of adults, and 2 studies of children and adults. In children, the pooled mean difference was 1.65 kg (95% confidence interval [CI]: 0.40, 2.90; 9 studies) for weight and 0.13 (95% CI 0.10, 0.17; 20 studies) for BMI z-scores, and the prevalence of obesity increased by 2% (95% CI 1%, 3%; 12 studies). In adults, the pooled mean difference was 0.93 kg (95% CI 0.54, 1.33; 27 studies) for weight and 0.38 kg/m2 (95% CI 0.21, 0.55; 25 studies) for BMI, and the prevalence of obesity increased by 1% (95% CI 0%, 3%; 11 studies). In children and adults, the pooled mean difference for waist circumference was 1.03 cm (95% CI -0.08, 2.15; 4 studies). There was considerable heterogeneity observed for all outcomes in both children and adults, and the certainty of evidence assessed using GRADE was very low for all outcomes. During the first year of the COVID-19 pandemic, small but potentially clinically significant increases in weight gain, BMI, and increased prevalence of obesity in both children and adults were observed. Increases were greater in children, and targeted prevention interventions may be warranted.
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Affiliation(s)
- Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nora Dewart
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ezza Jalil
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jayati Khattar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Carsley
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada.,Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.,Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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14
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Obesity and COVID-19 in Children and Adolescents: Reciprocal Detrimental Influence—Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137603. [PMID: 35805260 PMCID: PMC9266144 DOI: 10.3390/ijerph19137603] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 12/11/2022]
Abstract
The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection. The PubMed database was searched to identify original studies assessing: (1) the extent and risk factors of lockdown-induced weight increase; and (2) the impact of obesity on the risk of hospital admission in children and adolescents. A systematic literature review and meta-analyses were performed. Twenty out of 13,986 identified records were included. A significant weight increase was reported in the majority of subjects, with no apparent gender or age differences. It was induced by a higher consumption of hypercaloric/hyperglycemic/junk food and/or the reduction of physical activity, often associated with an altered sleep–wake cycle. On the other hand, obesity increased the risk of hospitalization (OR = 4.38; 95% C.I. 1.46–13.19; p = 0.009; I2 = 96%) as compared to the normal weight population. COVID-19 and obesity represent epidemic conditions with reciprocal detrimental impact. Urgent public health interventions, targeting the various age and social strata, and involving governmental authorities, health care personnel, teachers and families are warranted to increase awareness and actively promote healthy lifestyles to contrast pediatric obesity and its detrimental consequences at a global level.
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15
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Shalitin S, Phillip M, Yackobovitch-Gavan M. Changes in body mass index in children and adolescents in Israel during the COVID-19 pandemic. Int J Obes (Lond) 2022; 46:1160-1167. [PMID: 35173280 PMCID: PMC8852981 DOI: 10.1038/s41366-022-01092-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/05/2023]
Abstract
Background The current coronavirus disease 2019 (COVID-19) pandemic has health, social, and economic implications. Our primary objective was to evaluate changes in body mass index (BMI) from the pre-pandemic to COVID-19 pandemic period among a large pediatric population in Israel. Methods This retrospective cohort study is based on data from Clalit Health Services, the largest health maintenance organization in Israel. The data accessed included sociodemographic, anthropometric, and clinical parameters of persons aged 2–20 years with at least one BMI measurement during 2017–2019 (pre-pandemic period) and one between April 1, 2020 and December 31, 2020 (pandemic period). Results The cohort comprised 36,837 individuals (50.8% females); median age 11.2 years, 83.6% were Jewish and 10.3% of Arab ethnicity. BMI-SDS increased in both sexes (p < 0.001), in both ethnicities (p < 0.001), in all socioeconomic position clusters (p < 0.001), in children aged 2–18 years (P < 0.001), and in children with underweight or normal-weight in the pre-pandemic period (p < 0.001). For 21,610 individuals (35.6%), BMI-SDS increased ≥0.25 SD. The increase in BMI-SDS was greater in children aged 2–6 compared to 6.1–18 years; BMI-SDS decreased among those aged 18.1–20 years (P < 0.001). The increase in BMI-SDS was greater among those with underweight than normal weight; BMI-SDS decreased among those with overweight and obesity (P < 0.001). During the pandemic, overweight or obesity presented in 11.2% of those with normal weight in the pre-pandemic period; and obesity presented in 21.4% of those with overweight in the pre-pandemic period. Conclusions The COVID-19 pandemic correlated with overall weight gain among children and adolescents, with the most substantial weight gain in children aged 2–6 years. Notably, the most significant increase in BMI-SDS was observed in children with underweight; BMI-SDS decreased in children with overweight and obesity. Policies should be established during the pandemic that focus on increasing physical activity, reducing sedentary time, and promoting healthy diets.
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Affiliation(s)
- Shlomit Shalitin
- The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes Schneider Children's Medical Center of Israel, Petah Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Moshe Phillip
- The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Muhmann D, Droste M, Schulz J, Linge F, Ladewig L, Eisenberg U, Röder S, Büscher R. Schoolchildren from disadvantaged backgrounds present a loss of lean tissue mass and significant increase of body fat mass during the COVID-19 lockdown in Germany: results from the MEDdirect study. World J Pediatr 2022; 18:363-367. [PMID: 35322341 PMCID: PMC8942149 DOI: 10.1007/s12519-022-00541-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/03/2022] [Indexed: 12/05/2022]
Affiliation(s)
- David Muhmann
- University Hospital Essen, Pediatrics II, Hufelandstr. 55, 45147 Essen, Germany
| | - Marvin Droste
- University Hospital Essen, Pediatrics II, Hufelandstr. 55, 45147 Essen, Germany
| | - Jörn Schulz
- Be Strong for Kids E.V, Sundernholz 108, 45134 Essen, Germany
| | - Frederike Linge
- Schule Am Steeler Tor, Engelbertstr. 4, 45127 Essen, Germany
| | - Lea Ladewig
- Schule Am Steeler Tor, Engelbertstr. 4, 45127 Essen, Germany
| | | | - Susanne Röder
- Schule Am Steeler Tor, Engelbertstr. 4, 45127 Essen, Germany
| | - Rainer Büscher
- University Hospital Essen, Pediatrics II, Hufelandstr. 55, 45147, Essen, Germany.
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17
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Lubrecht J, Arayess L, Reijnders D, Hesselink ML, Velde GT, Janse A, von Rosenstiel I, van Mil EGAH, Verweij M, Vreugdenhil ACE. Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity. Obes Facts 2022; 15:600-608. [PMID: 35640561 PMCID: PMC9421665 DOI: 10.1159/000525298] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION School closures due to the COVID-19 pandemic affect children's daily structure, mealtimes, physical activity, and sleeping habits, possibly exacerbating weight gain, particularly in vulnerable children with overweight and obesity. This study aimed to evaluate both perceived and objectively measured weight gain in children in the Netherlands during the COVID-19 pandemic and the effect of prior lifestyle intervention. METHODS A total of 150 children of the Children, Obesity and Lifestyle during COVID-19 (COLC) study (cohort A) reported perceptions of weight change during the COVID-19 pandemic. Anthropometric data of 65 children with overweight and obesity were collected at the expertise Centre for Overweight Adolescent and Children's Healthcare in the same period (COACH; cohort B). RESULTS In cohort A, 43% of children with overweight and obesity perceived weight gain during the pandemic, compared to 15% of lean children. In cohort B, the BMI z-score increased significantly (+0.065 SD) within 5 months. Participation in a lifestyle intervention for >1 year and having parents with Dutch background was associated with less weight gain, specifically in children with obesity. DISCUSSION/CONCLUSION In particular, children with overweight and obesity seem to be at risk for accelerated weight gain during the COVID-19 pandemic. Prior long-term participation in a lifestyle intervention protects against this weight gain, which emphasizes the importance of strong support for vulnerable populations during health crises and pleads for wide implementation of lifestyle interventions for children.
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Affiliation(s)
- Judith Lubrecht
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre+, Maastricht, The Netherlands,
- School of Nutrition and Translational Research (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands,
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands,
| | - Lisanne Arayess
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre+, Maastricht, The Netherlands
- School of Nutrition and Translational Research (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Dorien Reijnders
- School of Nutrition and Translational Research (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marijn Lotte Hesselink
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Gabrielle Ten Velde
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Arieke Janse
- Department of Pediatrics, Gelderse Vallei Hospital, Ede, The Netherlands
| | | | - Edgar G A H van Mil
- Department of Pediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Marjoke Verweij
- Department of Pediatrics, VieCuri Medical Centre, Venlo, The Netherlands
| | - Anita C E Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre+, Maastricht, The Netherlands
- School of Nutrition and Translational Research (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands
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